<!DOCTYPE html>
<html>
<head>
  <meta charset="utf-8">
  <title>${sysName}</title>
  <meta name="renderer" content="webkit">
  <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
  <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
  <link rel="stylesheet" href="${resRoot}/layui/css/layui.css" media="all" />
  <link rel="stylesheet" href="${resRoot}/layui/admin/admin.css" media="all" />
	<link id="layuicss-layer" rel="stylesheet" href="${resRoot}/layui/css/modules/layer/default/layer.css" media="all">
</head>
<body>
<div class="layui-fluid">   
          <div class="layui-card">
          <div class="layui-form layui-card-header layuiadmin-card-header-auto"> 
 
<form class="layui-form" action="#" style="margin-top: 20px;margin-bottom:50px;" lay-filter="dataForm"  >
<input type="hidden" id="id" name="id"  >
  <div class="layui-form-item">
    <label class="layui-form-label">主键</label>
    <div class="layui-input-inline">
	      <input type="number" name="id" id="id" value=""  autocomplete="off" placeholder="请输入主键" class="layui-input" lay-verify="required|number" lay-reqtext="请输入主键" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入主键</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾人姓名</label>
    <div class="layui-input-inline">
	      <input type="text" name="name" id="name" value=""  autocomplete="off" placeholder="请输入残疾人姓名" class="layui-input" lay-verify="required" lay-reqtext="请输入残疾人姓名" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾人姓名</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">性别(1：男；2：女)</label>
    <div class="layui-input-inline">
	      <input type="number" name="sex" id="sex" value=""  autocomplete="off" placeholder="请输入性别(1：男；2：女)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入性别(1：男；2：女)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入性别(1：男；2：女)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">民族(1：汉族)</label>
    <div class="layui-input-inline">
	      <input type="number" name="nation" id="nation" value=""  autocomplete="off" placeholder="请输入民族(1：汉族)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入民族(1：汉族)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入民族(1：汉族)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">出生日期	</label>
    <div class="layui-input-inline">
	      <input type="text" class="layui-input" id="birthday"  onClick="WdatePicker({startDate:'%y-%M-%d 00:00:00',dateFmt:'yyyy-MM-dd HH:mm:ss',alwaysUseStartDate:true});" placeholder="yyyy-MM-dd" value="" lay-verify="required|date" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入出生日期	</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">证件类型(1:身份证;2:户口本;3:护照;4:军官证;5:士兵证;6:警官证;7:回乡证;8:通行证)</label>
    <div class="layui-input-inline">
	      <input type="number" name="certificateType" id="certificateType" value=""  autocomplete="off" placeholder="请输入证件类型(1:身份证;2:户口本;3:护照;4:军官证;5:士兵证;6:警官证;7:回乡证;8:通行证)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入证件类型(1:身份证;2:户口本;3:护照;4:军官证;5:士兵证;6:警官证;7:回乡证;8:通行证)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入证件类型(1:身份证;2:户口本;3:护照;4:军官证;5:士兵证;6:警官证;7:回乡证;8:通行证)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">证件号码</label>
    <div class="layui-input-inline">
	      <input type="text" name="certificateNo" id="certificateNo" value=""  autocomplete="off" placeholder="请输入证件号码" class="layui-input" lay-verify="required" lay-reqtext="请输入证件号码" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入证件号码</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾证号</label>
    <div class="layui-input-inline">
	      <input type="text" name="disabledNo" id="disabledNo" value=""  autocomplete="off" placeholder="请输入残疾证号" class="layui-input" lay-verify="required" lay-reqtext="请输入残疾证号" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾证号</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">固定电话</label>
    <div class="layui-input-inline">
	      <input type="text" name="fixPhone" id="fixPhone" value=""  autocomplete="off" placeholder="请输入固定电话" class="layui-input" lay-verify="required" lay-reqtext="请输入固定电话" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入固定电话</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾类型1:视力;2:听力;3:言语;4:肢体;5:智力;6:精神;7:多重)</label>
    <div class="layui-input-inline">
	      <input type="number" name="disabledType" id="disabledType" value=""  autocomplete="off" placeholder="请输入残疾类型1:视力;2:听力;3:言语;4:肢体;5:智力;6:精神;7:多重)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入残疾类型1:视力;2:听力;3:言语;4:肢体;5:智力;6:精神;7:多重)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾类型1:视力;2:听力;3:言语;4:肢体;5:智力;6:精神;7:多重)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾等级(1:一级;2:二级;3:三级;4:四级)</label>
    <div class="layui-input-inline">
	      <input type="number" name="disabledGrade" id="disabledGrade" value=""  autocomplete="off" placeholder="请输入残疾等级(1:一级;2:二级;3:三级;4:四级)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入残疾等级(1:一级;2:二级;3:三级;4:四级)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾等级(1:一级;2:二级;3:三级;4:四级)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾等级-肢体</label>
    <div class="layui-input-inline">
	      <input type="text" name="bodyLevel" id="bodyLevel" value=""  autocomplete="off" placeholder="请输入残疾等级-肢体" class="layui-input" lay-verify="required" lay-reqtext="请输入残疾等级-肢体" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾等级-肢体</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾等级-听力</label>
    <div class="layui-input-inline">
	      <input type="text" name="earLevel" id="earLevel" value=""  autocomplete="off" placeholder="请输入残疾等级-听力" class="layui-input" lay-verify="required" lay-reqtext="请输入残疾等级-听力" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾等级-听力</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾等级-视力</label>
    <div class="layui-input-inline">
	      <input type="text" name="eyeLevel" id="eyeLevel" value=""  autocomplete="off" placeholder="请输入残疾等级-视力" class="layui-input" lay-verify="required" lay-reqtext="请输入残疾等级-视力" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾等级-视力</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾等级-精神</label>
    <div class="layui-input-inline">
	      <input type="text" name="mentalLevel" id="mentalLevel" value=""  autocomplete="off" placeholder="请输入残疾等级-精神" class="layui-input" lay-verify="required" lay-reqtext="请输入残疾等级-精神" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾等级-精神</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾等级-智力</label>
    <div class="layui-input-inline">
	      <input type="text" name="iqLevel" id="iqLevel" value=""  autocomplete="off" placeholder="请输入残疾等级-智力" class="layui-input" lay-verify="required" lay-reqtext="请输入残疾等级-智力" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾等级-智力</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">残疾等级-言语</label>
    <div class="layui-input-inline">
	      <input type="text" name="speechLevel" id="speechLevel" value=""  autocomplete="off" placeholder="请输入残疾等级-言语" class="layui-input" lay-verify="required" lay-reqtext="请输入残疾等级-言语" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入残疾等级-言语</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">评残区县</label>
    <div class="layui-input-inline">
	      <input type="text" name="disabilityRatingArea" id="disabilityRatingArea" value=""  autocomplete="off" placeholder="请输入评残区县" class="layui-input" lay-verify="required" lay-reqtext="请输入评残区县" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入评残区县</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">领证区县</label>
    <div class="layui-input-inline">
	      <input type="text" name="getDisabledNoArea" id="getDisabledNoArea" value=""  autocomplete="off" placeholder="请输入领证区县" class="layui-input" lay-verify="required" lay-reqtext="请输入领证区县" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入领证区县</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">联系电话</label>
    <div class="layui-input-inline">
	      <input type="text" name="phone" id="phone" value=""  autocomplete="off" placeholder="请输入联系电话" class="layui-input" lay-verify="required" lay-reqtext="请输入联系电话" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入联系电话</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">监护人</label>
    <div class="layui-input-inline">
	      <input type="text" name="guardian" id="guardian" value=""  autocomplete="off" placeholder="请输入监护人" class="layui-input" lay-verify="required" lay-reqtext="请输入监护人" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入监护人</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">监护人电话</label>
    <div class="layui-input-inline">
	      <input type="text" name="guardianPhone" id="guardianPhone" value=""  autocomplete="off" placeholder="请输入监护人电话" class="layui-input" lay-verify="required" lay-reqtext="请输入监护人电话" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入监护人电话</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">与监护人关系（1：配偶；2：子；3：女；4：（外）孙（子/女）；5：父母；6：（外）祖父母；7：兄/弟/姐/妹；8：其他</label>
    <div class="layui-input-inline">
	      <input type="number" name="guardianship" id="guardianship" value=""  autocomplete="off" placeholder="请输入与监护人关系（1：配偶；2：子；3：女；4：（外）孙（子/女）；5：父母；6：（外）祖父母；7：兄/弟/姐/妹；8：其他" class="layui-input" lay-verify="required|number" lay-reqtext="请输入与监护人关系（1：配偶；2：子；3：女；4：（外）孙（子/女）；5：父母；6：（外）祖父母；7：兄/弟/姐/妹；8：其他" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入与监护人关系（1：配偶；2：子；3：女；4：（外）孙（子/女）；5：父母；6：（外）祖父母；7：兄/弟/姐/妹；8：其他</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">客户类型(1:独居;2:双老;3:孤老;4:离休干部;5:军休干部;6:困难老人;7:伤残人;8:老师)</label>
    <div class="layui-input-inline">
	      <input type="number" name="customerType" id="customerType" value=""  autocomplete="off" placeholder="请输入客户类型(1:独居;2:双老;3:孤老;4:离休干部;5:军休干部;6:困难老人;7:伤残人;8:老师)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入客户类型(1:独居;2:双老;3:孤老;4:离休干部;5:军休干部;6:困难老人;7:伤残人;8:老师)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入客户类型(1:独居;2:双老;3:孤老;4:离休干部;5:军休干部;6:困难老人;7:伤残人;8:老师)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">客户级别(1:普通；2:VIP)</label>
    <div class="layui-input-inline">
	      <input type="number" name="customerLevel" id="customerLevel" value=""  autocomplete="off" placeholder="请输入客户级别(1:普通；2:VIP)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入客户级别(1:普通；2:VIP)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入客户级别(1:普通；2:VIP)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">邮编</label>
    <div class="layui-input-inline">
	      <input type="number" name="postcode" id="postcode" value=""  autocomplete="off" placeholder="请输入邮编" class="layui-input" lay-verify="required|number" lay-reqtext="请输入邮编" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入邮编</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">监护人证件号码</label>
    <div class="layui-input-inline">
	      <input type="text" name="guardianCertificateNo" id="guardianCertificateNo" value=""  autocomplete="off" placeholder="请输入监护人证件号码" class="layui-input" lay-verify="required" lay-reqtext="请输入监护人证件号码" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入监护人证件号码</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">文化水平(1:文盲;2:小学;3:初中;4:高中;5中专;6:大专;7:本科;8:硕士;9:博士;10:其他)</label>
    <div class="layui-input-inline">
	      <input type="number" name="educationalLevel" id="educationalLevel" value=""  autocomplete="off" placeholder="请输入文化水平(1:文盲;2:小学;3:初中;4:高中;5中专;6:大专;7:本科;8:硕士;9:博士;10:其他)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入文化水平(1:文盲;2:小学;3:初中;4:高中;5中专;6:大专;7:本科;8:硕士;9:博士;10:其他)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入文化水平(1:文盲;2:小学;3:初中;4:高中;5中专;6:大专;7:本科;8:硕士;9:博士;10:其他)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">户籍类别(1:农业户口；2:非农业户口)</label>
    <div class="layui-input-inline">
	      <input type="number" name="censusRegisterType" id="censusRegisterType" value=""  autocomplete="off" placeholder="请输入户籍类别(1:农业户口；2:非农业户口)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入户籍类别(1:农业户口；2:非农业户口)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入户籍类别(1:农业户口；2:非农业户口)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">籍贯</label>
    <div class="layui-input-inline">
	      <input type="text" name="nativePlace" id="nativePlace" value=""  autocomplete="off" placeholder="请输入籍贯" class="layui-input" lay-verify="required" lay-reqtext="请输入籍贯" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入籍贯</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">评残日期</label>
    <div class="layui-input-inline">
	      <input type="text" class="layui-input" id="disabledRatingDate"  onClick="WdatePicker({startDate:'%y-%M-%d 00:00:00',dateFmt:'yyyy-MM-dd HH:mm:ss',alwaysUseStartDate:true});" placeholder="yyyy-MM-dd" value="" lay-verify="required|date" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入评残日期</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">领证日期</label>
    <div class="layui-input-inline">
	      <input type="text" class="layui-input" id="getCertificateDate"  onClick="WdatePicker({startDate:'%y-%M-%d 00:00:00',dateFmt:'yyyy-MM-dd HH:mm:ss',alwaysUseStartDate:true});" placeholder="yyyy-MM-dd" value="" lay-verify="required|date" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入领证日期</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">户籍区域</label>
    <div class="layui-input-inline">
	      <input type="text" name="censusRegisterArea" id="censusRegisterArea" value=""  autocomplete="off" placeholder="请输入户籍区域" class="layui-input" lay-verify="required" lay-reqtext="请输入户籍区域" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入户籍区域</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">户籍地址</label>
    <div class="layui-input-inline">
	      <input type="text" name="censusRegisterAddr" id="censusRegisterAddr" value=""  autocomplete="off" placeholder="请输入户籍地址" class="layui-input" lay-verify="required" lay-reqtext="请输入户籍地址" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入户籍地址</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">婚否(10:未婚;20:已婚;30:丧偶;40:离婚;90:其他)</label>
    <div class="layui-input-inline">
	      <input type="number" name="maritalStatus" id="maritalStatus" value=""  autocomplete="off" placeholder="请输入婚否(10:未婚;20:已婚;30:丧偶;40:离婚;90:其他)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入婚否(10:未婚;20:已婚;30:丧偶;40:离婚;90:其他)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入婚否(10:未婚;20:已婚;30:丧偶;40:离婚;90:其他)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">现居地址</label>
    <div class="layui-input-inline">
	      <input type="text" name="currentAddr" id="currentAddr" value=""  autocomplete="off" placeholder="请输入现居地址" class="layui-input" lay-verify="required" lay-reqtext="请输入现居地址" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入现居地址</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">信息录入来源(1:省残联接口插入；2:手动新增)</label>
    <div class="layui-input-inline">
	      <input type="number" name="inputSource" id="inputSource" value=""  autocomplete="off" placeholder="请输入信息录入来源(1:省残联接口插入；2:手动新增)" class="layui-input" lay-verify="required|number" lay-reqtext="请输入信息录入来源(1:省残联接口插入；2:手动新增)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入信息录入来源(1:省残联接口插入；2:手动新增)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">创建人</label>
    <div class="layui-input-inline">
	      <input type="text" name="creater" id="creater" value=""  autocomplete="off" placeholder="请输入创建人" class="layui-input" lay-verify="required" lay-reqtext="请输入创建人" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入创建人</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">创建时间</label>
    <div class="layui-input-inline">
	      <input type="text" class="layui-input" id="createTime"  onClick="WdatePicker({startDate:'%y-%M-%d 00:00:00',dateFmt:'yyyy-MM-dd HH:mm:ss',alwaysUseStartDate:true});" placeholder="yyyy-MM-dd" value="" lay-verify="required|date" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入创建时间</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">修改人</label>
    <div class="layui-input-inline">
	      <input type="text" name="updater" id="updater" value=""  autocomplete="off" placeholder="请输入修改人" class="layui-input" lay-verify="required" lay-reqtext="请输入修改人" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入修改人</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">修改时间</label>
    <div class="layui-input-inline">
	      <input type="text" class="layui-input" id="updateDate"  onClick="WdatePicker({startDate:'%y-%M-%d 00:00:00',dateFmt:'yyyy-MM-dd HH:mm:ss',alwaysUseStartDate:true});" placeholder="yyyy-MM-dd" value="" lay-verify="required|date" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入修改时间</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">户籍区域编号(省残联接口返回字段)</label>
    <div class="layui-input-inline">
	      <input type="text" name="censusRegisterCode" id="censusRegisterCode" value=""  autocomplete="off" placeholder="请输入户籍区域编号(省残联接口返回字段)" class="layui-input" lay-verify="required" lay-reqtext="请输入户籍区域编号(省残联接口返回字段)" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入户籍区域编号(省残联接口返回字段)</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">租户ID</label>
    <div class="layui-input-inline">
	      <input type="text" name="tenantId" id="tenantId" value=""  autocomplete="off" placeholder="请输入租户ID" class="layui-input" lay-verify="required" lay-reqtext="请输入租户ID" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入租户ID</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">删除状态（0：正常；1：删除）</label>
    <div class="layui-input-inline">
	      <input type="number" name="delStatus" id="delStatus" value=""  autocomplete="off" placeholder="请输入删除状态（0：正常；1：删除）" class="layui-input" lay-verify="required|number" lay-reqtext="请输入删除状态（0：正常；1：删除）" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入删除状态（0：正常；1：删除）</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">有效期开始</label>
    <div class="layui-input-inline">
	      <input type="text" class="layui-input" id="stime"  onClick="WdatePicker({startDate:'%y-%M-%d 00:00:00',dateFmt:'yyyy-MM-dd HH:mm:ss',alwaysUseStartDate:true});" placeholder="yyyy-MM-dd" value="" lay-verify="required|date" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入有效期开始</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">有效期结束</label>
    <div class="layui-input-inline">
	      <input type="text" class="layui-input" id="etime"  onClick="WdatePicker({startDate:'%y-%M-%d 00:00:00',dateFmt:'yyyy-MM-dd HH:mm:ss',alwaysUseStartDate:true});" placeholder="yyyy-MM-dd" value="" lay-verify="required|date" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入有效期结束</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">更改时间</label>
    <div class="layui-input-inline">
	      <input type="text" class="layui-input" id="utime"  onClick="WdatePicker({startDate:'%y-%M-%d 00:00:00',dateFmt:'yyyy-MM-dd HH:mm:ss',alwaysUseStartDate:true});" placeholder="yyyy-MM-dd" value="" lay-verify="required|date" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入更改时间</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">//持证有效状态（1持证2到期3迁出4注销5迁入过程中6冻结8已成功迁入其它地）</label>
    <div class="layui-input-inline">
	      <input type="text" name="state" id="state" value=""  autocomplete="off" placeholder="请输入//持证有效状态（1持证2到期3迁出4注销5迁入过程中6冻结8已成功迁入其它地）" class="layui-input" lay-verify="required" lay-reqtext="请输入//持证有效状态（1持证2到期3迁出4注销5迁入过程中6冻结8已成功迁入其它地）" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入//持证有效状态（1持证2到期3迁出4注销5迁入过程中6冻结8已成功迁入其它地）</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">同步标识（1:定时任务）</label>
    <div class="layui-input-inline">
	      <input type="text" name="isSync" id="isSync" value=""  autocomplete="off" placeholder="请输入同步标识（1:定时任务）" class="layui-input" lay-verify="required" lay-reqtext="请输入同步标识（1:定时任务）" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入同步标识（1:定时任务）</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">修改手机号（备用手机号）</label>
    <div class="layui-input-inline">
	      <input type="text" name="phone2" id="phone2" value=""  autocomplete="off" placeholder="请输入修改手机号（备用手机号）" class="layui-input" lay-verify="required" lay-reqtext="请输入修改手机号（备用手机号）" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入修改手机号（备用手机号）</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">户籍所在地 经度</label>
    <div class="layui-input-inline">
	      <input type="number" name="lon" id="lon" value=""  autocomplete="off" placeholder="请输入户籍所在地 经度" class="layui-input" lay-verify="required|number" lay-reqtext="请输入户籍所在地 经度" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入户籍所在地 经度</div>
  </div>

  <div class="layui-form-item">
    <label class="layui-form-label">户籍所在地 纬度</label>
    <div class="layui-input-inline">
	      <input type="number" name="lat" id="lat" value=""  autocomplete="off" placeholder="请输入户籍所在地 纬度" class="layui-input" lay-verify="required|number" lay-reqtext="请输入户籍所在地 纬度" >
    </div>
    <div class="layui-form-mid layui-word-aux">请输入户籍所在地 纬度</div>
  </div>


  <div class="layui-form-item">
    <div class="layui-input-block">
      <button class="layui-btn" id=""  lay-submit="" lay-filter="dataSaveSubmit"  type="button">立即提交</button>
      <button type="button" class="layui-btn layui-btn-primary" onclick="backList();" >返回</button>
    </div>
  </div>
</form>
</div>
  </div>
  </div>
<#include "/page/footer.html">
<script>
var id = "${id!}";
$(function(){


$(function(){
	var dataTmp = getDataById(id, "${base}/sys/clDisabledInfo/get/" + id)
})
});
function backList() {
	parent.layer.closeAll("iframe");
    //刷新父页面
    parent.location.reload();
}

function removeImg(id) {
	layer.confirm('您是确认删除/查看该图片吗？', {
		  btn: ['确认','查看'] //按钮
		}, function(){
			$("#" + id).attr("src", "");
			layer.msg('已删除！');
		}, function(){
			window.open($("#" + id).attr("src"));
		  //layer.msg('已取消！');
		});
}
layui.use(['form', 'layedit', 'laydate', 'upload'], function(){
  var form = layui.form
  ,layer = layui.layer
  ,layedit = layui.layedit
  ,laydate = layui.laydate;
  
  
  var upload = layui.upload;
  
  // 页面验证，及自定义验证规则 样例 表单验证参考  https://www.layui.com/demo/form.html
  form.verify({
    title: function(value){
      if(value.length == 0){
        return '参数不能为空';
      }
    }
    ,pass: [/(.+){6,12}$/, '密码必须6到12位']
    ,content: function(value){
      layedit.sync(editIndex);
    }
  });
  
  
  form.on('submit(dataSaveSubmit)', function(data){
      var index = layer.msg('加载中...',{icon: 16,time:false,shade:0.8});
      delete data.field.file;
      $.ajax({
			url : "${base}/sys/clDisabledInfo/save",
			contentType : "application/json",
         	dataType : 'json',
			data : JSON.stringify(data.field),
          	type:'post',
			async : true,
			success : function(data) {
				layer.close(index);
				console.log(data)
				if(data.code == 1) {
						layer.msg('保存成功！', {
						  icon: 1,
						  time: 2000 //2秒关闭（如果不配置，默认是3秒）
						}, function(){
							backList();
						});   
					} else {
						layer.msg(data.msg); 
					}
			}
		}); 
    });
  
});

layui.use('upload', function(){
	  
});  
</script>
</body>
</html>